| NPI | 1003179763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: PA 09611082) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 653021121) |
| 174400000X Specialist (Licence: NY 652874121) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2014-06-02 |